Deviated

A 15 year old girl presents with right-sided deviation of her mouth and difficulty closing her left eye for 1 day.

She also complains the food dribbles from the left side of her mouth. Her sense of taste is unaffected. There is no history of facial trauma.

Her medical history is unremarkable.

Select Relevant Investigations
Facial nerve biopsy

Performed

You realize that a facial nerve biopsy is probably not indicated.
MRI brain

Performed

The MRI of the brain shows enhancement of the distal intra-canalicular and labyrinthine segments of the facial nerve.
Electrodiagnostic studies

Performed

A nerve conduction study (NCS) and electromyogram (EMG) will be performed tomorrow.
Lumbar Puncture

Performed

Appearance: clear
Polymorphs: nil
Gram stain: negative
Glucose: 70 mg/dL (50 - 80)
Protein: 20 mg/dl (15 - 60)
Culture reports: Available in 3 days

Select Relevant Management
Corticosteroids
Antiviral treatment
Tarsorrhaphy
Antibiotics